VA Puget Sound Healthcare System - American Lake Division

They offer inpatient residential, outpatient, telemedicine and detox. The practical difference is whether you sleep at home or at the center, and are 8 other centers inside 14 miles if neither suits.

They detox from opioids, alcohol, benzodiazepines, cocaine and methamphetamines. Which substances a place handles matters more than the word detox, and none of the 8 centers near Tacoma offer one at all.

They treat both. A diagnosis left untreated while the substance use is treated is the usual reason a first attempt does not hold, and Lakewood is the nearest place to try instead if this one does not fit.

They treat adults from 26 to 64 and young adults from 18 to 25. The nearest alternative is in Lakewood, 3.8 miles away, if the age is the thing that rules this one out.

They prescribe methadone, buprenorphine and naltrexone, which is the part of treatment that is prescribed rather than attended. Of the 8 centers near Tacoma, not all of them do.

They treat people in Sign language as well as English, which not every place around Tacoma does.

Most of recovery happens after the program, which is an awkward fact for anyone selling programs. Outpatient care often continues for months after a residential stay, at a few hours a week. Ask how the medication prescription continues after discharge, and who writes it.

Treatment records for substance use are held under a federal rule that is stricter than the one covering ordinary medical records. Employers and courts normally receive attendance rather than clinical content. Ask who the center is allowed to speak to, and make sure the answer matches what you want.